Comparison of Intraperitoneal and Intraepididymal Quercetin for the Prevention of Testicular Torsion/Detorsion-induced Injury.

OBJECTIVE: To compare the effects of intraepididymal quercetin (IE-QE) with those of intraperitoneal quercetin (IP-QE) on testicular torsion/detorsion (TD)-induced ischemia/reperfusion (IR) injury of the testes in an experimental rat model. METHODS: Twenty-four rats were divided into 4 groups: sham (S), TD, TD treated with IP-QE, and TD treated with IE-QE. The IP-QE group received 20 mg/kg QE intraperitoneally, whereas the IE-QE group received quercetin (QE) epididymally. After surgically induced TD, sera and testicular tissues were obtained for the analysis of biochemical parameters including glutathione peroxidase (GPx), malondialdehyde, total antioxidant status, total oxidant status, oxidative stress index, histologic changes, and evaluation of germ cell apoptosis. RESULTS: The oxidative stress index and oxidants (malondialdehyde and total oxidant status) were increased with a concomitant decrease in the antioxidants (GPx and total antioxidant status) in the TD group. Severe histopathological damage, indicated by low Johnsen scores and high testicular injury grades, and germ cell apoptosis were found in the TD group compared with the other groups. Rats treated with QE showed significantly less IR injury, with moderately altered biochemical parameters, histopathological damage, and germinal cell apoptosis compared with the TD group. Most importantly, we found no significant differences in the biochemical parameters, histopathological changes, and germinal cell apoptosis between the IP-QE and IE-QE groups. CONCLUSION: IE-QE was comparable to IP-QE in the treatment of testicular TD. Local QE therapy should be considered as a new approach to treating testicular IR injury due to TD.

[Efficacy and safety of dapoxetine in the treatment of premature ejaculation].

OBJECTIVE: To evaluate the clinical effect and safety of dapoxetine in the treatment of premature ejaculation (PE). METHODS: We randomly assigned 116 PE patients to receive dapoxetine on demand at 30 mg qd (dapoxetine group, n = 60, aged 23-49 years) or oral tamsulosin at 20 mg qd (control group, n = 56, aged 24-46 years). After 4 weeks of medication, we compared the clinical global impression of change (CGIC) , PE profile (PEP) scores, intravaginal ejaculation latency time (IELT) , and adverse reactions between the two groups of patients. RESULTS: Compared with the baseline, the IELT was remarkably prolonged after treatment both in the dapoxetine group ([0.86 ± 0.17] vs [4.32 ± 2.23] min, P < 0.05) and the control ([0.88 ± 0.15] vs [4.17 ± 2.26] min, P < 0.05), with no statistically significant difference between the two groups (P > 0. 05). The post-treatment rate of CGIC in the dapoxetine group had no statistically significant difference from that in the control (85.00% vs 82.14%, P > 0.05). In comparison with pre-treatment, the patients of both the dapoxetine and control groups showed dramatically improved scores after medication in perceived control over ejaculation (0.85 ± 0.23 vs 2.13 ± 0.97 and 0.88 ± 0.21 vs 2.06 ± 0.34, both P < 0.05), ejaculation-related personal distress (1.15 ± 0.64 vs 2.89 ± 0.26 and 1.19 ± 0.53 vs 2.82 ± 0.69, both P < 0.05), satisfaction with sexual intercourse (0.81 ± 0.33 vs 2.58 ± 0.37 and 0.79 ± 0.28 vs 2.45 ± 0.32, both P < 0.05), and ejaculation-related interpersonal difficulty (2.05 ± 0.61 vs 3.24 ± 0.35 and 2.03 ± 0.65 vs 3.18 ± 0.76, both P < 0.05), with no significant differences between the two groups (P > 0.05). The incidence of adverse reactions was significantly lower in the dapoxetine than in the control group (3.33% vs 30.36%, P < 0.05). CONCLUSION: Dapoxetine is effective for the treatment of PE, with its advantages of prolonging the intravaginal ejaculation latency time, improving the quality of sexual life, and low incidence of adverse reactions.

Comparison of quercetin and resveratrol in the prevention of injury due to testicular torsion/detorsion in rats.

Quercetin (QE) and resveratrol (RSV) are powerful antioxidants with the potential to protect the testes against ischemia/reperfusion (I/R) injury. We compared their effects in testicular torsion/detorsion (T/D) in adult rats. Twenty-four male Wistar rats were divided into four groups: sham (group A), T/D (group B), T/D treated with QE (group C), and T/D treated with RSV (group D). QE (20 mg kg-1 ) and RSV (20 mg kg-1 ) were injected intra-peritoneally at 60 min of torsion. After 90 min of surgically induced torsion, the testicular cord was restored to its anatomical position. Twenty-four hour after torsion, blood and tissue samples were obtained for further examination. Testicular tissue malondialdehyde (MDA) and nitric oxide (NO) levels and serum total oxidant status (TOS) were higher in group B than in group A (P < 0.05). Group A had higher serum total antioxidant status (TAS) than group B. (P < 0.05) QE and RSV significantly lowered MDA, NO, and TOS levels and TAS consumption (P < 0.05). QE reduced the MDA and TOS levels more than RSV (P < 0.05), but their effects on NO reduction and TAS consumption were similar (P > 0.05). Group A had normal testicular architecture (grade 1). Groups C (mean grade 2.60) and D (mean grade 3.00) had lower testicular injury grades than group B (mean grade 3.45) (P < 0.05). Group C had lower testicular injury grade than group D (P < 0.05). Treatment with QE and RSV protects against I/R injury after testicular T/D. QE may exhibit better function than RSV at the doses tested in this study.